Euthanasia by Organ Donation - Doctors debate the dead donor rule.

Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

Several weeks ago I wrote about Dr Wes Ely's experiences while attending conferences on organ donation. Ely explains that the topic of euthanasia by organ donation was regularly being discussed at organ donation conferences. Ely, who opposes euthanasia, stated:

At each meeting, the conversation unexpectedly shifted to an emerging question of “death by donation” — in other words, ending a people’s lives with their informed consent by taking them to the operating room and, under general anesthesia, opening their chest and abdomen surgically while they are still alive to remove vital organs for transplantation into other people. 

The big deal here is that death by donation would bypass the long-honored dead donor rule, which forbids removal of vital organs until the donor is declared dead. Death by donation would, at present, be considered homicide to end a life by taking organs.

Sharon Kirkey published an article in the National Post (today) concerning the debate that has grown concerning euthanasia by organ donation. Kirkey explains:

Under this scenario, people granted an assisted death would, with their full knowledge and consent, be transported to an operating room, put to sleep under general anaesthesia and their organs removed, including the heart and lungs. Death would follow removal of the beating heart. Under so-called “euthanasia by organ donation,” the act of organ donation itself — not a lethal injection or a doctor-prescribed, life-ending dose of barbiturates — would be the mode of death.

According to Kirkey organ donation after euthanasia has already occurred at least 30 times in Canada, since euthanasia was legalized.

Kirkey points out that the dead donor rule prevents euthanasia by organ donation. 

An article published in the New England Journal of Medicine (NEJM) last September argues that eliminating the dead donor rule provides "benefits" by providing healthier organs for donation. Ian Ball, the lead author of the article explains the scenario:

The dead donor rule isn’t a law, but more an “ethical convention,” said Ball. It’s being questioned more, especially in the advent of assisted dying. “Prior to MAID it was absolutely unacceptable for physicians to intentionally and directly cause the death of a patient,” he said. 

“The extreme perspective — and I’m not taking this, I’m not advocating for this and it’s certainly against current MAID legislation, but some people do — is that, in the case of MAID, why wouldn’t you go to the operating room, get a general anaesthetic and why couldn’t they retrieve your beating heart? Because that would provide your heart in the best possible condition to a recipient.”

It's important to point out that Robert Troug, a long-time proponent of euthanasia by organ donation was also involved with the publishing of the article in the NEJM.

Kirkey finishes the article by asking Jennifer Chandler who works with Organ and Tissue donation at the University of Ottawa. Chandler suggests that many people would be uncomfortable with the idea of euthanasia by organ donation and it would lead to a grave risk to public trust.

Dr Ely stated in his article published in USA today that:

When physicians are participating in a procedure designed to take a person’s life, will patients feel 100% certain that their physician is firmly on the side of healing? What message does it send about the value of every human life when physicians endorse the exchange of one life for another? What affect has it already had on physicians complicit in such death-causing procedures?

The problem begins when society permits doctors, or others, to kill people. If euthanasia by organ donation becomes an accepted way to kill, then sadly, euthanasia will be promoted as a benefit to society creating another pressure to die.